Wiki Use of modifier 50 in ASC

[LMO312]

My eye group has several ASC's and I have been asked to help with some coding denials. I am new to ASC billing and have a couple of questions. The main one is regarding modifier 50. Is modifier 50 allowed or do charges ( ie YAG on both eyes) need to be billed on separate lines with RT/LT? Also, I'm having issues with V2587, corneal tissue processing. Is this a billable procedure code? I would appreciate any help or suggestions.

Thanks.

 

[Edmundo]

Hi LMO312,

Great question! It varies when coding for professional or facility. Modifier 50 is appropriate when coding professional. Separate line items with RT/LT are appropriate when coding facility.

For example: Patient X comes in for a bilateral YAG procedure.

Professional - CPT 66821, 50
Facility - CPT 66821, RT (First line item)
Facility - CPT 66821, LT (Second line item)

Best of luck coding Ophthalmology!


Edmundo Gonzalez, CPC, COPC, OCS

 

[LMO312]

Thank you, Edmundo!

 

[LMO312]

Edmundo,

I have another question regarding 92136. Should the 1st eye be billed 92136-TC and the 2nd eye be billed RT/LT, 26 or should it be billed 92136 rt/lt and then the 2nd eye 92136-TC?

thanks.

 

[gflanery11]

Edmundo,

I have another question regarding 92136. Should the 1st eye be billed 92136-TC and the 2nd eye be billed RT/LT, 26 or should it be billed 92136 rt/lt and then the 2nd eye 92136-TC?

thanks.

The first 92136 is billed with no modifier. The second is billed with 26. Hope this helps.